Healthcare Provider Details

I. General information

NPI: 1780614677
Provider Name (Legal Business Name): VICTOR HYMAN ASHEAR PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 07/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1262 WEST 5TH ST.
SHERIDAN WY
82801
US

IV. Provider business mailing address

1433 STONEGATE DR
SHERIDAN WY
82801-4042
US

V. Phone/Fax

Practice location:
  • Phone: 307-674-6166
  • Fax: 307-672-8687
Mailing address:
  • Phone: 307-672-3135
  • Fax: 307-672-8687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number111
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: